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Nathan Greer

Counsel

Health Care Regulatory · Philadelphia

Nathan Greer is brought in when a health care provider receives a letter from the government that puts its revenue or its license at risk: a Medicare contractor’s audit ending in an extrapolated overpayment demand, a state inspection followed by a notice of revocation, a compliance officer’s discovery that a physician was paid for two years under an agreement that had expired. He is counsel in Harwell Brandt’s Health Care Regulatory Group and appears before the Pennsylvania Department of Health, the Pennsylvania Department of Human Services, and each level of the Medicare appeals process. His clients are home health and hospice agencies, personal care homes, community hospitals, physician practices and medical equipment suppliers.

Representative matters

  1. Represented a home health agency in Delaware County in a Medicare post-payment audit by a Unified Program Integrity Contractor, which reviewed a sample of the agency’s claims and extrapolated an overpayment across three years of billing. Lead counsel through redetermination and reconsideration and at the hearing before an administrative law judge of the Office of Medicare Hearings and Appeals, working with a statistician to challenge the sampling method. At stake: a repayment demand larger than the agency’s annual operating margin, and recoupment that could begin once reconsideration was decided.

  2. Advised a community hospital after its compliance officer found that the written agreement with one of its medical directors had expired while the monthly payments continued. Led the review of the hospital’s financial arrangements with referring physicians under the federal physician self-referral law and the Anti-Kickback Statute, and drafted the hospital’s submission under the CMS Voluntary Self-Referral Disclosure Protocol, with the chair of the group. At stake: repayment of the Medicare claims tied to the lapsed arrangement, and the exposure that follows an overpayment kept past the sixty-day deadline for reporting and returning it.

  3. Represented the operator of a personal care home in Berks County after the Department of Human Services cited the home following an inspection and moved to revoke its license. Lead counsel on the appeal to the department’s Bureau of Hearings and Appeals, and negotiated the plan of correction and the monitoring terms under which the home continued to operate while the appeal was pending. At stake: the license, and the placements of the forty residents who lived there.

  4. Defended a durable medical equipment supplier in a qui tam action under the False Claims Act in the Eastern District of Pennsylvania, after the United States declined to intervene. Second chair with the firm’s Litigation Group; drafted the motion to dismiss for failure to plead fraud with the particularity that Federal Rule of Civil Procedure 9(b) requires. At stake: treble damages and per-claim penalties across several thousand claims.

Representative matters describe the lawyer’s role and what was at stake. Each matter turned on its own facts and law, and prior results do not guarantee a similar outcome.

How the work is done

He starts with the deadline. A Medicare appeal, a licensing appeal and a response to an audit each run on a short clock, and his first letter to a client lists every date that applies and what happens if it passes. Before a provider answers an audit, he has the records reviewed by a clinician the firm retains, so the client knows which claims will hold before arguing for any of them. He reads a regulation the way the agency’s lawyers will, because for five years he was one of them. When an inquiry could become a fraud investigation, he brings in the Litigation Group before any employee is interviewed.

Before Harwell Brandt

He was an associate in the health care group of a Philadelphia firm from 2011 to 2014. From 2014 to 2019 he was Assistant Counsel to the Pennsylvania Department of Health, representing the department in licensing and enforcement matters involving hospitals, ambulatory surgical facilities and home health agencies. He joined Harwell Brandt in 2019 and became counsel in 2023.